Nonsteroidal anti-inflammatory drugs (NSAIDs) in the newborn – which ones?

Abstract

Objective. To determine which nonsteroidal anti-inflammatory drugs (NSAIDs) are being used in newborns.

Methods. NSAID use was examined in local neonatal units and in published literature indexed by PubMed.

Results. Various NSAIDs are being used in newborns. Indomethacin and ibuprofen are used worldwide for closure of patent ductus arteriosus (PDA). Both have been tested in randomized clinical trials and are approved by FDA and EMEA for PDA closure in newborns. Indomethacin, but not ibuprofen is used for prevention of intraventricular hemorrhage (IVH). Ketorolac is being studied as a potential parenteral analgesic and as a topical drug for prevention of oxygen-induced retinopathy. Others are associated with severe adverse events.

Conclusion. NSAIDs remain as active drugs used for PDA closure and IVH prevention. Potential uses including analgesia and retinopathy prevention are currently being studied.

Keywords:

• NSAIDs
• newborns
• ibuprofen
• indomethacin